Gallstone ileus : A possible cause of bowel obstruction in the elderly population

Monti, Marco; Cestaro, Giovanni; Alkayyali, Suleiman; Galafassi, Jacopo; Fasolini, Fabrizio

doi:10.1016/j.ijscr.2018.01.010

Cited by 9 publications

(14 citation statements)

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“…Por ello es importante incluirlo en el diagnóstico diferencial de la oclusión intestinal de intestino delgado. Prácticamente en todos los casos existe una fístula que comunica la vesícula biliar con la luz del tracto gastrointestinal, siendo la más frecuente la colecistoduodenal 1,2 . Es frecuente encontrar una fístula asociada, la que puede no estar presente en el momento del diagnóstico.…”

Section: Discussionunclassified

“…El lugar más común donde se produce dicha impactación es el íleon terminal, aunque se puede encontrar en cualquier parte del tracto gastrointestinal. El acceso de la litiasis biliar a la luz intestinal se debe a la presencia de una fístula que comunica la vesícula con el intestino 1,2 . Procesos inflamatorios recurrentes, cuadros de colecistitis aguda, favorecen la formación de dicha fístula, siendo la más frecuente la fistula colecistoduodenal 3 .…”

Section: Introductionunclassified

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Ileo biliar. Reporte de casos

2020

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Introduccion: El íleo biliar es una causa poco frecuente de obstrucción intestinal mecánica, siendo más frecuente en pacientes mayores de 65 años y sexo femenino.Casos clínicos: Se exponen cuatro casos clínicos diagnosticados de íleo biliar, intervenidos en nuestro centro.Discusión: El íleo biliar es una enfermedad que se produce a consecuencia del paso de un cálculo al lumen intestinal. Esto se produce por la presencia de una fistula entre la vesícula y el intestino, localizada mayormente a nivel duodenal. Se manifiesta con una clínica muy inespecífica, lo que condiciona un retraso en su diagnóstico. La tomografía computarizada es actualmente el exámen de elección. El tratamiento consiste en la enterotomía con extracción del cálculo, realizándose la reparación de la fístula en un primer o segundo tiempo. Tiene un mal pronóstico debido a comorbilidad de los pacientes y la demora diagnóstica y terapéutica.

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Section: Discussionunclassified

Section: Introductionunclassified

Ileo biliar. Reporte de casos

2020

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“…The intermittence of symptoms could also interfere with a correct diagnosis, if the clinical manifestations at the moment correspond to a partial obstruction or a distal migration of the gallstones. Patients usually present 4-8 days after the onset of symptoms, and diagnosis is usually made 3-8 days after the onset of symptoms [1,2,29,[32][33][34][35][36][37][38]. A high index of suspicion will be useful, particularly in an elderly patient with intestinal obstruction and previous gallstone disease; Bouveret syndrome can be suspected in a patient with gastric outlet obstruction.…”

Section: Diagnosismentioning

confidence: 99%

Gallstones Ileus

Petracca¹,

Zappia²,

Silvaggio³

2020

Intestinal Obstructions

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The ileus of gallstones is a rare complication of cholelithiasis which occurs in less than 1% of patients and is the cause of 1-4% of cases of obstruction of the small intestine. The pathogenesis involves the formation of a bilioenteric fistula. Abdominal computed tomography (CT) shows pneumobilia, dilated loops of small intestine, and ectopic gallstones that obstruct the intestinal lumen. In literature, enterolithotomy is the most frequently used procedure for the ileum of gallstones. Enterolithotomy plus cholecystectomy and/or fistulectomy are indicated only in selected patients. The clinical signs and symptoms depend on the site of the obstruction and usually include abdominal pain, nausea, and vomiting. The diagnostic test of choice is an abdominal CT scan.

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“…A rare complication of cholelithiasis is gallstone ileus. It occur when a stone passes from a gallbladder into the intestinal tract, due to a biliaryenteric fistula mostly cholecystoduodenal fistula [1].…”

Section: Introductionmentioning

confidence: 99%

Non-typical gallstone ileus: case report

Tareef¹,

Bayan²,

Abdelrahman³

et al. 2020

World J. Adv. Res. Rev.

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Gallstone ileus (GI) is a complication of gallstone disease causing mechanical intestinal obstruction due to impaction of gallstone in the gastrointestinal tract. It accounts for less than 1-4% of the cases. It is more common among elderly female. Nowadays diagnosis of GI became more reliable and easier using radiological modalities such as abdominal CT/MRI scanning although still the mortality and morbidity considered to be high in such diagnosis. This is a case of gallstone ileus in a 73-year-old woman. Initially, plain X-ray showed signs of intestinal obstruction with large radiopaque shadows seen in right upper and lower quadrant of the abdomen. The diagnosis was made by MDCT scan which showed unfamiliar findings that are: unusual stone location that impacted in the jejunum, incomplete Rigler's triad as there was no pneumobilia and a 2.6 cm ectopic stone that appeared to be larger postoperatively. Patient underwent urgent laparotomy with enterotomy where a 4 cm gallstone was removed and intraoperative exploration for the rest of the bowel revealed another stone in the sigmoid colon that was initially detected by MDCT which milked toward the rectum. Post-operative course was uneventful. Abdominal X-ray can be used a preliminary tool for intestinal obstruction in general. Although abdominal CT scan is the investigation of choice to diagnose gallstone ileus, accurate size and number still under debate. Pneumobilia is not a common finding and Rigler's triad advised to be revised. Intraoperative exploration is necessary to rule out other stones.

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Gallstone ileus : A possible cause of bowel obstruction in the elderly population

Cited by 9 publications

References 10 publications

Ileo biliar. Reporte de casos

Ileo biliar. Reporte de casos

Gallstones Ileus

Non-typical gallstone ileus: case report

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